Session:

Date

Location

Presenting author

Maggie Hendry

Contact person

Maggie Hendry

Abstract text

Background
The UK has the highest rate of teenage pregnancies in Western Europe, resulting in significant emotional, psychological and educational harm, often with enduring effects on life chances for mothers and babies. In this review we use a structured, innovative and iterative methodological approach to address a complex topic; reducing unintended repeat pregnancies.
Objectives
With the aim of informing policy makers, objectives are:
• To quantify the evidence for interventions used and estimate which are effective, how they work, in what setting, and for whom
• To determine who is at greater risk of repeat unintended pregnancies
• To identify the barriers and facilitators to intervention uptake
• To estimate the cost-effectiveness of interventions
A parallel aim is to further develop mixed method review methodologies.
Methods
We will conduct a mixed-method systematic review to examine world-wide literature on repeat teenage pregnancies (figure 1). Traditional database searches will be augmented by targeted searches for evidence “clusters” (qualitative studies, programme evaluations, etc. associated with effectiveness studies).
A mapping exercise will be undertaken to describe the literature, identify evidence gaps, and provide a context for interpreting the results and a basis for refining the scope of the review. We will be guided by experts and stakeholders including teenage parents.
Where clinical homogeneity and data exists quantitative methods will be used to summarise the evidence. These will include meta-analyses of incidence of pregnancy, and the effectiveness of interventions. We will also carry out a meta-regression to explore possible effect modifiers. The qualitative data addressing facilitators and barriers to uptake (feasibility), experience (appropriateness), and acceptability (meaningfulness) will synthesised thematically. We will apply the principles of realist synthesis to evidence of theories and mechanisms underpinning interventions (what works, for whom and in what context). Finally we will conduct an overarching narrative synthesis and interpretation of findings.